Mews Claudia, Eisele Marion, Boczor Sigrid, Scherer Martin
Universitätsklinikum Hamburg-Eppendorf. Institut und Poliklinik für Allgemeinmedizin, Hamburg, Deutschland.
Universitätsklinikum Hamburg-Eppendorf. Institut und Poliklinik für Allgemeinmedizin, Hamburg, Deutschland.
Z Evid Fortbild Qual Gesundhwes. 2020 Sep;155:40-47. doi: 10.1016/j.zefq.2020.06.004. Epub 2020 Aug 14.
For patients with diabetes mellitus, training is an essential part of therapy. There is a lack of empirical data regarding training experiences for people with a (Turkish) migration background and low literacy skills concerning the established training programmes. The objective of this research was to collect data from general practices based on their experiences in training these particular groups of patients.
In a quantitative cross-sectional study design, 795 general practices throughout Germany with the additional designation of diabetology were invited via e-mail to participate in a fully structured, standardised online survey. An exploratory data analysis was performed using the statistics software IBM SPSS.
Out of 146 participating practices (response rate 18%), 66 (45%) estimated the proportion of patients with migration background in their practice to be more than 20%. Approximately 76% of the practices providing diabetes training (n=119) trained patients of Turkish origin. Forty six percent of these practices estimated the ratio of patients of Turkish origin with low literacy skills to be 10 to 50%. Less than 36% of the practices were aware of suitable training programmes for this target group. Existing programmes were modified to special needs and new materials creatively developed. Additional culturally sensitive and visually enriched materials are needed. Forty two percent of the interviewed practices reported billing difficulties concerning frequently needed individual trainings.
Training was carried out in different ways due to individual addition or deletion of content elements. There is a lack of evaluated materials that are adapted to the users' cultural background and level of education. In the face of a significantly changed immigration structure, information and materials as well as interpreters for additional languages are increasingly required.
Further development of evidence-based, multi-lingual, image-based, culturally sensitive and educationally diverse materials and training units and their scientific evaluation is needed. Learning contents adapted to the level of education and promoting cultural sensitivity in the provision of healthcare should be implemented increasingly in the training and continuous professional development of health professionals.
对于糖尿病患者而言，培训是治疗的重要组成部分。关于具有（土耳其）移民背景且对既定培训项目识字能力较低的人群的培训经历，缺乏实证数据。本研究的目的是根据普通诊所培训这些特定患者群体的经验收集数据。
在一项定量横断面研究设计中，通过电子邮件邀请德国各地795家设有糖尿病专科的普通诊所参与一项结构完整、标准化的在线调查。使用统计软件IBM SPSS进行探索性数据分析。
在146家参与调查的诊所中（回复率18%），66家（45%）估计其诊所中具有移民背景的患者比例超过20%。提供糖尿病培训的诊所中约76%（n = 119）培训了土耳其裔患者。这些诊所中有46%估计识字能力较低的土耳其裔患者比例为10%至50%。不到36%的诊所知晓针对该目标群体的合适培训项目。现有项目针对特殊需求进行了修改，并创造性地开发了新材料。还需要更多具有文化敏感性和视觉丰富性的材料。42%接受访谈的诊所报告称，在频繁需要的个体培训方面存在计费困难。
由于内容元素的个别增减，培训方式各异。缺乏适合用户文化背景和教育水平的经过评估的材料。面对显著变化的移民结构，对额外语言的信息、材料以及口译员的需求日益增加。
需要进一步开发基于证据、多语言、基于图像、具有文化敏感性且教育方式多样的材料和培训单元，并对其进行科学评估。应在卫生专业人员的培训和持续专业发展中越来越多地实施适应教育水平并在提供医疗保健时促进文化敏感性的学习内容。
